International Family Medicine physicians are family physicians that specialize in working with under-served populations in resource-poor environments, often in developing nations. These physicians face the challenge of diagnosing patients without advanced laboratory or imaging techniques. Because of limited access to medications and specialists, International Family Medicine physicians must have flexible treatment strategies and a broad scope of practice. History Peter Parker, MD was one of the earliest full time American medical missionaries in 1834. He opened an ophthalmology hospital in China. Many physicians have worked in developing nations over the years. Surgeons and primary care physicians alike have donated their time or their entire lives to needy populations in the world. Modern Organizations such as Doctors Without Borders (Médecins Sans Frontières) organize physicians from around the world to provide disaster medicine and relief work during times of extreme need or natural disasters. Interest in international medicine among medical students and residents has been increasing. Many medical schools and residencies are offering global health tracks. Family Medicine physicians, because of their broad scope, are particularly well suited for practicing in areas where specialists are not readily available. For those family physicians that desired full time careers in international medicine would generally begin their work immediately after residency. Because of the varied conditions of the developing world versus the training environment there is often a very steep learning curve for Western trained family physicians. In response to improving the preparedness for American Family Physicians International Family Medicine Fellowships have emerged recently. These fellowships aim to better prepare Family Medicine graduates for the challenges that they will face overseas. The need for physicians well suited for international challenges is greatly needed, especially in areas with large refugee populations. Scope of Practice Family physicians that practice in the United States have the broadest scope of all of the specialties. Family physicians frequently treat illnesses related to obstetrics, pediatrics, adult medicine, orthopedics, outpatient and inpatient care. International Family Medicine physicians must also manage tropical medicine, surgery, anesthesia, burn care, HIV, and even dentistry. In addition to the medical challenges, International Family Medicine physicians must often act as hospital administrators as well. The issues faced often range from obtaining local pharmaceuticals and supplies to repairing broken medical equipment. Engaging the public health issues of communities relating to sanitation and clean water is yet another task that falls on the wide shoulders of the physician. Cultural differences